Conference Corner October 2013
Thank you to Rehabilitation Hospital of Wisconsin for hosting the ½ day conference on August 21, 2013. Over 20 people came to enjoy the 3 speakers.
The first speaker was Nancy Kennedy PhD, discussing the role of neuropsychology in the rehabilitation setting. Nancy differentiated rehab psych versus neuropsych, in addition to psychiatry. She discussed the reasons why referrals would be written for each of the areas. She also covered common screening tools used including the mini mental exam, Montreal Cognitive Assessment, and the Repeatable battery for the Assessment of Neuropsychological Status (RBANS). Components of a neuropsych evaluation was included in her presentation; memory, attention, language, visuospatial abilities, executive functions, and mood. Additional information was provided on memory testing, dementia, and Alzheimer’s disease.
The second speaker was Jessica Formea, MS/CCC-SLP. Jessica presented on cognitive coaching in rehabilitation. She covered what cognitive coaching is and the various areas of cognitive functioning, in addition to possible causes of cognitive impairment. The main focus of the presentation was on cognitive coaching strategies including visual aids, working with the difficult patient, and additional referrals needed.
The third and final speaker presented on cognitive effects of medication s in the elderly. Michelle Long RPh, discussed drugs that cause cognitive impairment and risk factors leading to the impairment. Elderly patients are more susceptible to drug induced cognitive impairment for a variety of reasons. The list of medications that could potentially lead to cognitive impairment was really eye opening because they are common drugs that we see given to a lot of our patients. Strategies to prevent drug induced cognitive impairment in the elderly was discussed and include administering the least number of medications possible, adjusting doses for renal and hepatic function, encouraging elderly patients to discuss over the counter medications with their physician or pharmacist, avoiding high risk medications where possible, and being familiar with known risk factors for cognitive impairment.
Conference Corner May 2012
SAVE THE DATE: April 29 — Full-day WARN Education Conference at Waukesha County Technical College
Conference Corner May 2012
WARN has had another successful annual education conference. 39 attendees heard 6 information packed presentations, participated in the silent auction and networked with friends not seen since the last WARN conference.
The morning session began with Sheila Weix MSN, RN, CARN, LNC speaking about substance abuse in rehab. The statistics shared about our state wer quite remarkable. Key Point – do NOT assume that your rehab patient has detoxed upon their arrival to your rehab program as this may not be the case. Be alert for signs and symptoms of delirium and treat appropriately. Susan Fadness MSW, LSW began with some statistics that really opened our eyes. Did you know that informal caregivers provide more care in the home than the federal government provides in all settings combined? In her presentation she shared information from AARP that states that 42.1 million family caregivers in 2009 care to adults with limitations in daily activities and 61.6 million caregivers intermittently provided care in 2009. The strain caused by being a caregiver can result in a long list of physical and psychological symptoms. The good news is that there are a lot of resources available to support caregivers. Don’t forget them in the discharge planning process. Judy Klaver MSN, RN caught us up on the Future of Nursing in Wisconsin by highlighting the key things that are impacting rehab practice. At the end of the presentation attendees were able to describe the IOM report and provide strategies implemented or are in development in the state of Wisconsin that support the recommendations outlined in the IOM report.
Over lunch Terry Gion conducted a WARN board meeting with updates from each of the board members. Joyce shared process for revising the bylaws. A vote was taken and the proposed changes were accepted. In addition Lindsay Crow from UW-Madison received the Rising Star award. (add photo and parts nomination) Sarah Musselman, also from UW-Madison, received the Nursing Excellence Award. (add photo and parts nomination) Each year WARN makes a donation to a worthy organization that provides services to those with disabilities in Wisconsin. This year the $250 donation went to Acres of Hope & Aspiration is located in Muskego, WI. This organization helps clients and their families recover, rehabilitate and overcome and compensate for deficits sustained from a brain injury. Clients can face lives worth living as they embark on a new but different journey that provides support, motivation and hope.
The afternoon sessions began with Julie Millenbruch PhD, RN, CRRN- sharing data from her dissertation. Her study used a qualitative approach to explore education related to sexuality post stroke. Participants were asked to answer 8 questions about interactions with health care providers focusing on sexuality. Julie shared candid, direct quotes from those 8 questions. It was fascinating to hear their perceptions.
Sue Gresser MS, RN, GCNS-BC- shared how the CJZVAMC integrated benevolent touch into their daily cares. A bit of history was provided on the origins of benevolent touch as well as the limited scientific evidence describing the benefits of benevolent touch. don’t need empirical evidence to know that touch can make you feel better. Sue reminded us that it does not take a lot of time to provide that touch that reminds our patients, and us, that we care. Everyone working in our profession knows that the patients are sicker, and there is a lot more involved in caring for them. Many say that the days of back rubs and hand holding are long gone, do they have to be? Steve Ohly RN, NP from Walker’s Point closed the afternoon with an informal open discussion forum about the power of nursing. He asked us to remember why we chose to become a nurse and what keeps us in this profession.
The Silent auction raised $760 for WARN. Thank you to all who participated in the auction and congratulations to those who took a basket home with them. See you all next year.
Conference Corner February 2012
Highlights from WARN half day conference.
Monica Diamond PT, MS, D/NDT presented on the challenges of mobility, positioning, spasticity and tone in rehab patients. She had an interactive session demonstrating the difficulty of using incorrect techniques when mobilizing patients and the need to use correct techniques to facilitate mobility while keeping the patient and staff member safe. She discussed the difference between spasticity and tone and provided information on how to mange hypo and hypertonicity.
Laura Gaudynski OTR/L presented a brief update on ADL activities. (She was not listed as a presenter. Marty asked multiple times if she was going to present and was told no. Then she presented for about 5 minutes).
Jennifer Kennedy MD presented on spasticity. She discussed the effects, advantages and disadvantages of spasticity. Treatment options included oral medications, nerve blocks, chemodenervation, botox injections, Intrathecal baclofen therapy, surgical options and therapy interventions. She presented to case studies which demonstrated treatment and outcomes of spasticity management.
Conference Corner February 2011
Thank you to Aurora St. Luke’s Medical Center for hosting the January ½ Day conference. About 25 people came to enjoy 3 speakers.
The first speaker was Dr. Scott Hardin. It was pretty obvious that he is passionate about spinal cord injury. He is fascinated by the way the body works and he made it easy for us to understand too. A brief review of anatomy and physiology led into a discussion and practice session on the ASIA scale. This discussion segued into the innovations and future treatments for SCI.
The second speaker was Mary Milliren. She is the current nurse manager for the St. Luke’s inpatient rehab unit. She spoke about how important it is for rehab nurses to highlight the important role they play in getting patients home. PTs, OTs & ST often take front stage in rehab programs and take away from the contributions of the nurse. Although this is not a new concept it is time to remind nurses that it is time to raise our voices so others can hear and better understand what we do.
Do you know your superpowers? Nicole Eull PhD likes to remind us all that we all have strengths – you just need to look for them. Even the most challenging coworker , patient or family member holds within them some positive traits that if identified can be channeled to be a positive. Nicole did a version of this presentation for the nursing staff and there was a palpable change in energy on the unit.
Highlights from our most recent half day program, hosted by Ministry St. Joseph’s
Healthcare rehab unit, in Marshfield, WI. By Marty Castillo
Despite the difficulties of a low attendance, which may have been both economically
driven as well as by the distance to travel for many, the staff at St. Joe’s outdid
themselves putting together a wonderfully informative program for us!
Opening the program with Kathleen Buffington, OD, FCOVD provided participants
with an informative discussion on visual deficits that can impact many of our patients,
especially those with brain injuries. She then provided everyone with a “tool kit”, and
instructed us on techniques to complete various evaluations. What a wonderful reminder
that there are things that we as nurses can do to improve the quality of life for our
Following a break, Sheila Weix, CARN, BSN, MSN, LNC was very engaging as she
gave some insight regarding the impact of substance abuse and addiction on the rehab
patient. Everyone who heard her speak was tremendously appreciative of the important
information that she presented, and left wanting to learn more about this very important
and timely issue.
WARN member to be published
Congratulations to Lisa Salamon, who’s manuscript "IDENTIFICATION OF PATIENTS AT RISK FOR FALLS IN AN INPATIENT REHABILITATION PROGRAM” was recently accepted for publication in Rehabilitation Nursing.
For the last several years WARN has donated money to the Wheelchair Recycling
Center. Joyce Ennis recently went on a mission trip to Guatemala. While there
she was able to get a wheelchair for one of the people she was there to serve.
To read more about Joyce's experience, click here.
***Conference Corner May 2011 ***
When we planned last year for this year’s annual education conference who would have
thought that the Packers would win the superbowl. And WOW!! Lambeau Field is a great place
to celebrate the successes of rehab nurses. Many people came up early or stayed late to tour
the stadium and the hall of fame or to shop for gear at the pro shop.
When we got down to business on Monday the day began with Bobbie Spitz from Aurora Visiting Nurses speaking on wounds and the transition from inpatient rehab to home care. Terry Gion did a presentation that contained stories that we could all relate to about delirium in the brain injured rehab patient.
Lunch time offered a great meal and the opportunity to network with people not seen
since the last conference. The battle for the baskets in the silent auction heated up as people
had time to critically think about their contents.
The afternoon began with Maria Brenny Fitzpatrick (below) addressed “Medication Concerns for your Geriatric Patients”.
Linda Lansverk & Judy Klaver (below) partnered up to speak on documentation.
Closing the day was Lisa Salamon with Teaching tricks of the trade.
**Conference Corner Feb 2011**
Thank you to Aurora St. Luke’s Medical Center for hosting the January ½ Day conference. About 25 people came to enjoy three speakers. The first speaker was Dr. Scott Hardin. It was pretty obvious that he is passionate about spinal cord injury. He is fascinated by the way the body works and he made it easy for us to understand too. A brief review of anatomy and physiology led into a discussion and practice session on the ASIA scale. This discussion segued into the innovations and future treatments for SCI.
The second speaker was Mary Milliren. She is the current nurse manager for the St. Luke’s
inpatient rehab unit. She spoke about how important it is for rehab nurses to highlight the important role they play in getting patients home. PTs, OTs & ST often take front stage in rehab programs and take away from the contributions of the nurse. Although this is not a new concept it is time to remind nurses that it is time to raise our voices so others can hear and better understand what we do.
Do you know your superpowers? Nicole Eull PhD likes to remind us all that we all have strengths – you just need to look for them. Even the most challenging coworker, patient or family member holds within them some positive traits that if identified can be channeled to be a positive.
Nicole did a version of this presentation for the nursing staff and there was a palpable change in energy on the unit.
**November 2010 Conference Corner**
By Lisa Salamon
The cold and rainy weather did not deter people from attending the half day program hosted by Theda Clark in Neenah Wisconsin.
As is tradition the program started out with a brief update from the WARN board. Dr. Tom VanSistine a physiatrist at Theda Clark filled the first hour presenting the historical continuum of multiple sclerosis. I believe that every person in the audience learned something about this disease that was not known prior to the presentation. Current treatments were discussed and questions from the audience led to discussion on some alternative treatments.
Scott Powley MD followed with a presentation on spasticity. Video clips demonstrated how an EMG is performed to pinpoint the particular muscle where medications such as Botox are injected to decrease spasticity. It was fascinating and highlighted why you want to make sure that your MD is truly practiced in this procedure before you proceed.
John Burke PhD spent his hour focusing on the caregivers. He provided many of the common challenges that caregivers face and then offered some ways that can be used to adapt to being a caregiver. A particularly helpful portion of the talk is the internet resources that were shared that focus on caregiving. I have included several at the end of this article.
We finished up the afternoon with Kim Sawall sharing her unique perspective of being an occupational therapist who worked with MS patients and now has been diagnosed with MS herself.
**October 2010 Conference Corner**
If you weren’t one of the 31 attendees at Bellin Hospital for the ½ day education program on Aug. 11 you missed a great stroke update. Dr. David Heverly began the program with “stroke for non-golfers”. He imbedded humor into a complicated topic that made it easy to learn. The graphics used throughout the presentation reviewed the anatomy frequently involved in stroke.
Dr. Jason Schave is the physiatrist the rehab nurses at Bellin work with on a daily basis. He won over the crowd with prizes of chocolate rewarded for those participating in quiz questions throughout his presentation. Dr. Schave reminded us of how important it is to understand how medications can influence the successful progression of patients through a rehab stay. He received a lot of positive comments thanking him for the pharmacology review.
Often the first caregiver to see a patient is a nurse and it is important to be able to partner with speech therapy to evaluate our patient’s ability to swallow safely. Susan Fedo-Rosvold MA/CCC, SLP shared why it is so important.
The afternoon wrapped up with Deb Fewell PT reviewing some strategies for save patient handling. Susan Fedo-Rosvold represented a patient with a left sided stroke as Deb demonstrated how to handle some of the challenges we face with patients experiencing issues with mobility.
At the break we held a make-up election for the next WARN board. Voting is such an important part of your role as a member of WARN and I would like to thank you for participating. I would like to extend an invitation to you to consider running for a board position yourself. If you would be interested in receiving more information please contact any board member for additional information.
Thank you to all of those at Bellin who worked to offer such a great program.
Susan L. Heser RN BSN CRRN, Restorative Nurse Coordinator on the conference: "We had a wonderful time, learned a lot, and got some great ideas from the vendors. The appetizers the first night were really nice, much more than I expected, the continental breakfasts were great. We had time in the evenings to do things with family. We were exhausted when we got home. I am definitely going agin next year in Las Vega. It would be nice to have attendees from Wisconsin get together for a quick introduction and picture next year."
Heser attended with Cassandra Miller from the Tomah VA Medical Center.
*Spring Conference Corner*
The 2010 WARN Annual Education Day was held at Chula Vista Resort in the beautiful Wisconsin Dells on April 19, 2010. Participants spent the day learning about Brain Injury.
The day began with an extremely interesting overview of brain injury from the neurosurgical perspective, even including a video of a craniotomy for tumor removal! Lesley Bitters RN, a neurosurgical nurse from BayCare Clinic, was a wonderful presenter, explaining many of the details about diagnostics, treatments and outcomes. Andrea Pfaffl followed Leslie talking about the Medicare Final rule and how it impacts our IRP patients.
During lunch break the Rising Star in Rehabilitation and the Excellence in Nursing awards were presented. For the first time we had nine nominations. Also for the first time we felt it necessary to recognize two nominees in both categories because they were neck and neck when we compared them to the criteria for each of the awards. Jennifer Ertel (from UW Hospitial) and Kate Bussmann (from Aurora St. Luke’s) won the Rising Star award. Meaghan Ward (from aurora St. Luke’s) and Terri Gion (from UW Hospital) won the Excellence awards. See the photos and nominations here to learn why they were chosen). Participants also were encouraged to visit the vendor tables and to bid on the exciting offerings in the annual silent auction fundraiser.
After lunch, Nicole Eull PhD was an excellent speaker; educating the group about the emotional changes that come with a life changing diagnosis, and suggestions on how to interact with patients and family who are impacted by this.
Two of Froedtert's outpatient therapists (Laurie Dulitz and Bill Reinhard) discussing strategies for community re-entry and Joyce Ennis sharing her experiences as the spouse of a brain injury patient rounded out the afternoon.
This was a wonderful opportunity for rehab nurses from many venues across the state to not only expand their knowledge, but also network with their peers.
*January Conference Corner*
WARN would like to thank Sacred Heart Rehab in Eau Claire and all of their speakers for inviting us to “Rising to New Heights” the most recent WARN ½ Day Education Program on January 13, 2010. The day offered information on new technology and updates on current therapeutic interventions.
We opened the afternoon with a presentation by Richard Bryans, director of therapies at Sacred Heart on a device used with aphasia patients. The Lingraphica is an easy-to-use, full-featured communication device. It provides an extensive vocabulary of icons you can combine to create personalized phrases and simple sentences that speak in a natural-sounding voice. For more information on this great tool go to http://www.aphasia.com/patients/product_features.aspx.
The second speaker Dr. John Lamourex provided his insights on the value of the rehab nurse.
Julie Mumford states “music therapy, simply put, is the use of music to achieve non-musical goals”. Music is universal and non-threatening. It is frequently associated with important events in one’s life and for these reasons music often reaches people when other treatment methods do not. The literature has shown that music can accesses motor, cognition, language and the social emotional and spiritual areas of the person. Julie Mumford asks that we don’t forget the value of music when you are working with your patients.
Paula Zematis OTR, CLT provided a clinical review of lymphedema and its treatments, a brief session on the Bioness and the show stealer… an introduction to PLEO a one week-old baby Camarasaurus dinosaur that they use as an alternative therapy. Pleo is a robot that interacts with you - moving organically, expressing emotion, autonomously exploring and responding to the world around him. Pleo's sophisticated sensory system has devices that enable him to hear, to see, to sense touch, and to detect objects. The audience had a hard time concentrating as we passed the little fella around. Go to http://store.pleoworld.com to see the online demo.
The last speaker of the day, Dr. Michael Lace Psy.D, reminded us how important it is to take care of ourselves while we take care of our patients. The patients we care for are complex and they stay with us for extended periods of time allowing us to become part of their lives. We were reminded that balancing life & work and managing stress are essential to our personal wellbeing and the ability to come back day after day and provide excellent care to our patients and their families. Our take home assignment was to write a personal mission statement, much like those of the facilities that we work for, that will help to keep our paths true.
ARN 35th Annual Education Conference - Albuquerque, N.M.
Several Wisconsin rehab nurses tried to escape the dreary Midwest weather for the ARN 35th annual education conference in Albuquerque New Mexico. The days were in the upper 60’s and the nights cool and in the upper 30’s. Over 700 nurses from across the country were in attendance and Wisconsin was well represented with 10 people there, four presented. Anne Leclaire had a paper presentation on VADs in a rehab setting. Terri Goin presented 2 papers: 1 a case study and the second on TBI and falls. Lisa Salamon and Marty Castillo co-presented a paper on shared governance and a poster on gingerbread villages to lighten up the holiday.
As a first time attendee to the two day leadership pre-conference I was captivated by Virginia Beeson MSN, CNAA on day one talking about the essentials of leadership. Many real life situations were discussed with a lot of excellent ideas on strategies to handle them. Day two focused on how these leadership skills can be utilized within ARN and state chapters. ARN is looking for future leaders and we encourage you to become involved in our local chapter to develop your knowledge and skills to maybe one day work on the national level.
The general conference sessions offered a wide variety of topics to choose from. As always there were lots of opportunities to catch-up with old friends and many more opportunities to make new friends. Old Town Albuquerque showcased a lot of local wares and good New Mexican style food.
Next year’s conference is Sept 29th – Oct 2nd in Orlando Florida. Start thinking about what projects you might want to highlight. I would be more than happy to mentor/coach you through the process. Thinking about the first step is worse than actually taking it.